Chun Gao, Min Chen, Yi Xin Tong, Li Zhu, Sheng Zhang
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Outcomes were measured using hazard ratios (HRs) derived from univariate or multivariate analyses. Meta-analyses were performed using RevMan, pooling hazard ratios with 95% confidence intervals (CIs) using both fixed and random-effects models.</p><p><strong>Results: </strong>A total of 22 studies encompassing 11,954 CRC patients were included in the analysis. The meta-analysis indicated that higher levels of SAT were significantly associated with longer OS (HR: 0.77, p < 0.05) and DFS (HR: 0.61, p < 0.05). In contrast, VAT showed no significant correlation with OS or DFS. No publication bias was detected in the correlation between VAT/SAT and survival outcomes.</p><p><strong>Conclusions: </strong>The findings suggest that elevated subcutaneous adiposity is linked to improved OS and DFS in colorectal cancer patients. These insights highlight the prognostic significance of SAT over VAT in CRC. 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引用次数: 0
摘要
背景：脂肪组织分布对结直肠癌（CRC）患者临床预后的潜在影响已越来越被认识到。本研究系统地回顾和分析了内脏和皮下脂肪与CRC患者生存结局之间的关系。方法：对MEDLINE、PubMed、谷歌Scholar、Embase、Cochrane Library、Web of Science等多个数据库进行综合文献检索，检索截止到2024年10月的出版物。研究的选择是基于对CRC患者脂肪指标（内脏脂肪组织[VAT]、皮下脂肪组织[SAT]、VAT/SAT比率）与总生存期（OS）或无病生存期（DFS）之间关系的研究。使用单变量或多变量分析得出的风险比（hr）来测量结果。使用RevMan进行meta分析，使用固定效应和随机效应模型合并95%置信区间（ci）的风险比。结果：共有22项研究包括11954例结直肠癌患者被纳入分析。meta分析显示，较高的SAT水平与较长的OS （HR: 0.77, p < 0.05）和DFS （HR: 0.61, p < 0.05）显著相关。相比之下，VAT与OS或DFS无显著相关性。在VAT/SAT与生存结果之间的相关性中未发现发表偏倚。结论：研究结果表明，结直肠癌患者皮下脂肪升高与OS和DFS的改善有关。这些见解强调了CRC中SAT比VAT的预后意义。需要进一步的大规模研究来证实这些结果并探索潜在的机制。
Unlocking the Fat Factor: How Adiposity Shapes Survival in Colorectal Cancer--A Comprehensive Meta-Analysis.
Background: Adipose tissue distribution has been increasingly recognized for its potential impact on clinical outcomes in colorectal cancer (CRC) patients. This study systematically reviews and analyzes the relationship between visceral and subcutaneous adiposity and patient survival outcomes in CRC.
Methods: A comprehensive literature search was conducted across multiple databases including MEDLINE, PubMed, Google Scholar, Embase, Cochrane Library, and Web of Science, covering publications up to October 2024. Studies were selected based on their examination of the association between adiposity metrics (visceral adipose tissue [VAT], subcutaneous adipose tissue [SAT], VAT/SAT ratio) and overall survival (OS) or disease-free survival (DFS) in CRC patients. Outcomes were measured using hazard ratios (HRs) derived from univariate or multivariate analyses. Meta-analyses were performed using RevMan, pooling hazard ratios with 95% confidence intervals (CIs) using both fixed and random-effects models.
Results: A total of 22 studies encompassing 11,954 CRC patients were included in the analysis. The meta-analysis indicated that higher levels of SAT were significantly associated with longer OS (HR: 0.77, p < 0.05) and DFS (HR: 0.61, p < 0.05). In contrast, VAT showed no significant correlation with OS or DFS. No publication bias was detected in the correlation between VAT/SAT and survival outcomes.
Conclusions: The findings suggest that elevated subcutaneous adiposity is linked to improved OS and DFS in colorectal cancer patients. These insights highlight the prognostic significance of SAT over VAT in CRC. Further large-scale studies are warranted to corroborate these results and explore the underlying mechanisms.
期刊介绍：
Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
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